title: Immunopathological characteristics of immune reconstitution inflammatory syndrome caused by Mycobacterium parascrofulaceum infection in a patient with AIDS.
abstract: Immune reconstitution inflammatory syndrome (IRIS) caused by mycobacterium in patients with AIDS is often experienced in clinical practice. There is, however, a paucity of data documenting the histopathological findings and the pathogenesis. We determined the immunopathological characteristics of IRIS associated with Mycobacterium parascrofulaceum infection in an AIDS patient. A patient presented with pulmonary lymphadenitis and involvement of the pulmonary lingular segment. Portions of the involved lymph nodes and lung were excised, and the immunological properties were analyzed by immunohistochemical assays. The histological characteristics of lymph nodes showed a caseous necrosis. Histopathologically, the pulmonary lesion was composed of exudative and proliferative lesions. CD4(+), CD8(+), CD57(+), and CD25(+)/FoxP3(+) cells were observed in both types of lesions. Clusters of CD20(+) cells and GATA3(+) cells were predominantly observed in exudative lesions, while T-bet(+) cells were dominant in proliferative lesions. ROR-γ(+) cells were also observed in exudative lesions. These results indicate that the cellular immunity to mycobacteria was recovering in the lung tissue. In M. parascrofulaceum pulmonary infection, the exudative lesion had characteristics of Th2 and Th17-type immunities. In contrast, the proliferative lesion had characteristics of Th-1 type immunity. Our data provide the first evidence to reveal the status of the axis of distinctive immunity in the process of granuloma formation caused by a mycobacterium-related infection.
authors.affiliation: Department of Infectious, Respiratory, and Digestive Medicine, Control and Prevention of Infectious Diseases, Faculty of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan. kenjihibiya@gmail.com
authors.forename: Kenji
authors.initials: K
authors.lastname: Hibiya
authors.forename: Masao
authors.initials: M
authors.lastname: Tateyama
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Teruya
authors.forename: Hideta
authors.initials: H
authors.lastname: Nakamura
authors.forename: Daisuke
authors.initials: D
authors.lastname: Tasato
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kazumi
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Hirayasu
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Tamaki
authors.forename: Shusaku
authors.initials: S
authors.lastname: Haranaga
authors.forename: Futoshi
authors.initials: F
authors.lastname: Higa
authors.forename: Shinji
authors.initials: S
authors.lastname: Maeda
authors.forename: Jiro
authors.initials: J
authors.lastname: Fujita
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications* / Q000175:diagnosis; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000175:diagnosis; D000328:Adult; D000906:Antibodies; D023241:Antiretroviral Therapy, Highly Active; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D007150:Immunohistochemistry; D008168:Lung / Q000382:microbiology / Q000473:pathology; D008198:Lymph Nodes / Q000382:microbiology / Q000473:pathology; D008206:Lymphatic Diseases / Q000382:microbiology / Q000473:pathology; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000150:complications* / Q000175:diagnosis; D009170:Nontuberculous Mycobacteria / Q000472:pathogenicity*; D012141:Respiratory Tract Infections / Q000150:complications / Q000175:diagnosis; D014057:Tomography, X-Ray Computed
chemical_list: D000906:Antibodies